Gac Sanit.

2021;35(S1):S23–S26

Analyzing the use of pesticides on health complaints of farmers

in Waihatu Village, Indonesia
Hamka a , Tri Niswati Utami b,∗ , Sahrir Sillehu a , Aulia Debby Pelu a , Jayanti Djarami a ,
Suryanti Tukiman a , Ira Sandi Tunny a , Astuti Tuharea a , Sunik Cahyawati a
a
Institute of Health Science Maluku Husada, Indonesia
b
Department of Occupational Health and Safety, Universitas Islam Negeri Sumatera Utara, Medan, Indonesia

a r t i c l e i n f o a b s t r a c t

Article history: Objective: The study aimed to find the factors that contributed greatly to health complaints due to use of
Received 24 August 2020 pesticides.
Accepted 4 December 2020 Method: The research using the cross-sectional research design. The sample was determined using a total
sampling technique. Data analysis was performed by path analysis using Smart PLS.
Keywords: Results: The result of the study found that the use of pesticides affected the working time t-statistic 3.467.
Health complaints The use of pesticides affects health complaints t-statistic 2.586. Types of pesticides affect working time
Types of pesticides
t-statistic 2. Improper timing of spraying and the frequency of spraying has a bigger impact on farmers’
Time of spraying
health complaints.
Conclusions: Spraying time has the greatest influence on health complaints. It is recommended that
farmers reduce the frequency of spraying more than 2 times a day, spraying time in the morning, and
pay attention to the wind direction to reduce exposure and health hazards due to pesticides.
© 2020 SESPAS. Published by Elsevier España, S.L.U. This is an open access article under the CC
BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Introduction
Based on doctor’s medical records, occupational diseases in Nor-
way totaled 648 cases and 469 of them occurred in farmers reaching
a higher rate (72.4%). Some of the complaints of farmers related
to work include skin diseases, respiratory problems, allegedly due
to exposure to chemical work environment factors (pesticides),
the lowest percentage of musculoskeletal disorders, and mental
disorders.1 WHO data sources note that workers in the agricul-
tural sector experience pesticide poisoning of 1–5 million cases per
year.2
Pesticide poisoning cases in Indonesia, according to the Food
and Drug Administration, recorded 775 cases.3 Cases of pesticide
poisoning in several 55 farmers (63.96%).4 The horticultural farm-
ers in Ngablak District, Magelang Regency, experienced a balance
disorder of 34.3% and 14.3% abnormal blood cholinesterase levels.5
Individuals exposed to pesticides have a greater risk of developing
cancer than those who are not exposed to pesticides. the pesti-
cides contain ingredients that cause cancer, and cancer is a chronic
impact due to pesticides. The greatest potential for cancer to occur
in farmers is leukemia.6
The mechanism of pesticides and chemicals enters the body
in 3 ways, namely: inhalation, skin absorption, and mouth
(swallowing).7 Pesticides that enter the human body it will affect
Peer-review under responsibility of the scientific committee of the 1st Interna-
tional Conference on Safety and Public Health (ICOS-PH 2020). Full-text and the
content of it is under responsibility of authors of the article.
∗ Corresponding author.
E-mail addresses: triniswatiutami@uinsu.ac.id, pmc@agri.unhas.ac.id
(T.N. Utami).
the physiology and biochemistry in the body and damage enzymes.
The nervous system is the target of organochlorine pesticides.8 The
serious conditions of health problems due to pesticides are deter-
mined by several factors, namely: the type of pesticide, the use of
mixing pesticides, spraying, storage, exposure time, the mechanism
of the pesticide entering the body, and pesticide levels. Pesticide
exposure to body balance disturbances was significantly influenced
by 3 variables: length of work, length of work, and use of personal
protective equipment.5 The harmful effects of pesticides due to
farmers’ lack of knowledge, using pesticides in the wrong way, and
the wrong attitude while using pesticides.9
The farmers who use personal protective equipment while
working in the healthy category, and farmers who do not use
personal protective equipment find several complaints that are
felt such as dizziness, shortness of breath, frequent urination,
numbness of the fingers, and blurred vision.10 Spraying activ-
ity causes farmers to be exposed to pesticides longer. This
exposure can be reduced by designing spraying machines, this
has been done by farmers in India, spraying using a drone
machine.11
A preliminary survey found that 68 horticultural farmers, some
of the farmers used pesticides not according to the safe dosage
recommended by the Ministry of Health, a reason to maximize
yields. Likewise, when spraying is done several times, includ-
ing spraying is done 2–3 times a day, when spraying is done
in the morning then treating other plants, continued spraying in
the afternoon, and in the evening. The assumption that health
complaints felt by farmers were thought to be mediated by the
timing of spraying, in contrast to the findings of the four previous
researchers.

https://doi.org/10.1016/j.gaceta.2020.12.007
0213-9111/© 2020 SESPAS. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-
nd/4.0/).
S24 Hamka et al. / Gac Sanit. 2021;35(S1):S23–S26
Table 1
Social demographic characteristics of horticultural farmers.
Characteristics Frequency
Age
25–43 34
44–61 26
62–79 8 11.8
Education
Primary school 51
Secondary school 11
Senior high school 6 8.8
Years of service (years)
<10 17
10–20 21
>20 30
Source: Primary Data, 2019.
Method
This type of correlational research, using a cross-sectional
design. This study does not have a difference in the time dimen-
sion between the variables studied.12 The research was conducted
in September–November 2019 on horticultural farmers in Wai-
hatu Village, Indonesia. Population of 68 horticultural farmers. The
sample was determined using a total sampling technique.
Data were collected using a questionnaire. Data analysis used by
path analysis. The advantage of this analysis is that it can be seen
that the relationship pattern of the 5 variables studied is direct or
indirect.13 The hypothesis was tested based on a significant level
of 0.05 and t-statistic >1.96, the hypothesis was accepted.
Results
The characteristics of the research respondents are given in
Table 1.
The majority of respondents aged 25–43 years as many as 34
people (50%), based on education level, the majority of primary
schools are 51 people (75%) and the majority of the working period
>20 years 30 people (44.1%) (Fig. 1).
Analysis of 5 variables along with their indicators, shows that
all variable indicators of pesticide use, type of pesticide, years of
service, working time, and health complaints are declared valid.
Table 2 shows the test results for 4 hypotheses are declared
significant. The use of pesticides affects working time (p-
value = 0.001), the use of pesticides affects health complaints
(p-value = 0.010), the type of pesticides affects working time
(p-value = 0.005), and working time affects health complaints
(p-value = 0.027). The rejected hypothesis was that the type
of pesticide did not affect health complaints (p-value = 0.257)
and tenure had no effect on health complaints (p-value
= 0.115).
Discussion
The majority of respondents aged 25–43 years as many as 34
people (50%) are of productive age. The productive age according
to the ministry of health is 15–64 years.14 The horticulture sector
provides the largest income contribution per year, followed by the
livestock sector, non-agricultural sector, and finally food crops.15
The majority of horticultural farmers in Cameroon are male.16 The
number of cases of occupational disease in farmers is higher in
men in the age range of 55–74 years.17 The characteristics of the
majority of farmers are male, the farming community in Jember
Regency considers that spraying pesticides is a job that is appro-
priate for men. All horticultural farmers who sprayed the male
gender.18
The majority of elementary schools are 51 people (75%). The use
of pesticides and health hazards to farmers in Cameroon, the major-
Percentage ity of junior high school level as many as 62.5%.16 Education level is a
stage of the formal path that a person takes, and influences the abil-
50 ity to think, understand, accept, and act. Willingness to accept and
38.2 follow health regulations as long as it is possible to spray pesticides
is influenced by educational background. In this regard, the Min-
istry of Health said that the agricultural sector in Indonesia needs to
75 take strategic steps to prevent the dangers of pesticides to farmers
16.2
by empowering farmer groups and cross-sector support.2
Knowledge and practice of farmers’ pesticide use in Zambia,
requires local government support in the form of basic training.
25
The results of the study found that safe procedures including use,
30.9
44.1 handling, storage, and disposal were influenced by the knowledge,
experience, and counseling of the local government. Have never
received a basic education and have never received training from
the government and related institutions.19 Previous research on
411 farmers in Iran found that farmers who used pesticides to
increase crop yields chose pesticides based on the following crite-
ria: information about pesticides, effectiveness, use techniques,
environmental factors, and price and availability of pesticides.20
The findings of this study indicate that farmers do not consider
the effects and types of pesticide use on health. The provisions for
choosing a pesticide must consider the minimal effect on health
problems. WHO states that the classification and types of pesti-
cides are based on uses and hazards to health, based on exposure
to pesticides by mouth and skin, and types of pesticides, solid or
liquid-based on pesticide levels LD50 (mg/kg body weight).1 The
Ministry of Health has provided the types of pesticides that are
legally registered in Indonesia issued by the Ministry of Agriculture
so that farmers can use the recommended types of pesticides based
on the farmer’s ability, quality, and legalization from the Ministry
of Health.2 Farmers use more than 3 types of pesticides to quickly
kill pests. This has a very negative impact on health. Because it has
a bigger effect. The use of more than several types of pesticides will
accumulate toxins so that the risk of pesticide poisoning is greater.
This study found that the type of pesticide had no direct effect on
health complaints, but the type of pesticide that was mediated by
the working time affected the health complaints of farmers. There-
fore farmers need to choose the working time or the spraying time.
Observation results found that some farmers sprayed 2–3 times a
day, namely in the morning and afternoon. Of course, it causes farm-
ers to be exposed to pesticides more often. Farmers do repeated
spraying in a short period because farmers spray themselves. The
hope of getting the most from agriculture causes farmers to spray
using pesticides for a long time and continuously. The farmers’
pesticide use in Zambia is influenced by farmers’ low knowledge
of pesticide safety. Farmers are also not trained in pesticide use,
storage and spraying, creating problems for the environment and
farmers’ health.19
The majority of farmers have a service life of >20 years, and
the results of the study show that tenure does not affect farm-
ers’ health complaints. The farmers who have a longer working
period have a longer experience so they are careful to use pesticides.
Farmers have also adapted and are familiar with the procedures
for using pesticides. Experiences in determining good pesticide use
practices.19 The farmers follow the spraying requirements accord-
ing to the recommendations listed on the pesticide bottle so that
they do not exceed the frequency of spraying. The effects of pesti-
cides can last a long time that shows that short-term and long-term
exposure has different effects on health.6 That pesticide exposure
is not felt immediately at this time, it can have long-term effects
because of its cumulative nature.
The farmers’ knowledge has a significant relationship with
the safe use of pesticides. Farmers who have higher knowledge
and education prefer to use pesticides safely. Farmers choose
 Hamka et al. / Gac Sanit. 2021;35(S1):S23–S26 S25

Fig. 1. Pathway analysis of the relationship of health complaints.

Table 2
Analysis of the hypothesis test pathway for farmers’ pesticide use.

Variable Original sample Sample mean Standard deviation t-Statistic p-value

Use of pesticides → working time 0.365 0.357 0.105 3.467 0.001*

Use of pesticides → health complaints 0.333 0.338 0.129 2.586 0.010*
Types of pesticides → working time 0.320 0.338 0.114 2.808 0.005*
Working time → health complaints 0.298 0.301 0.134 2.227 0.027*

Source: Primary Data, 2019.

pesticides that have low health effects. During the spraying process,
use personal protective equipment such as hats, masks, fully closed
clothes, and boots and carry out health checks if symptoms of pesti-
cide poisoning are found.21 Unsafe behavior was found through the
same research by Joko (2020) that excessive use of pesticides was
carried out to maximize crop yields including spraying 2–3 times,
mixing pesticides 5–7 types.10 Researchers observed that farmers
used unsafe pesticides during storage, put pesticides in the kitchen,
and were also found by farmers putting on terraces exposed to the
sun.
The statistical model test, the type of pesticide has no direct
effect on health complaints, but the type of pesticide is mediated
by working time which affects health complaints. Even though they
contain chemicals, the safety of pesticides is determined based on
the level of chemical threshold values allowed according to the
Ministry of Health of the Republic of Indonesia.22 The use of pes-
ticides has provisions for safety standards, even the Ministry of
Health provides a wide variety of alternatives. Types of pesticides
in the safe category if used at the wrong time, for example spray-
ing with a frequency of morning, afternoon, evening, have an effect
on health complaints. Some of the factors that were not observed
in this study were farmer knowledge, use of personal protective
equipment, smoking habits, and personal hygiene.
Conclusions
Spraying time that exceeds the recommended standard results
in health complaints. The use of pesticides such as mixing, spray-
ing, and storing affects health complaints. During this process, the
farmer is in contact with chemicals based on the mechanism by
which pesticides enter the human body. Skin exposure during mix-
ing, airborne during spraying, and oral exposure during storage.
Support from related sectors is needed, to provide guidance and
increase knowledge of farmers about the process of using pesti-
cides, choosing working hours (spraying) according to personal
safety standards to minimize the effects of using pesticides both
in the short and long term.
Conflicts of interests
The authors declare that they have no conflict of interest.
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